Curr Health Sci J, vol. 42, no. 3, 2016

T.S. TENEA-COJAN⁽¹⁾, CLAUDIA VALENTINA GEORGESCU⁽²⁾, OANA-MARIA CORICI⁽¹⁾, B. VOINEA⁽³⁾, DIANA MONICA GEORGESCU⁽⁴⁾, C. VIDRIGHIN⁽⁵⁾, D. ILIE⁽⁵⁾, I. PAUN⁽¹⁾

⁽¹⁾Surgery Clinic, Clinical Hospital C.F. Craiova,
⁽²⁾Pathological Anatomy of Emergency Hospital of Craiova,
⁽³⁾Gynaecology Departament of Filantropia Hospital of Craiova,
⁽⁴⁾Student, University of Medicine and Pharmacy of Craiova,
⁽⁵⁾Surgery, Municipal Hospital of Caracal

Abstract:

In this histopathological study we looked at 303 cases of breast carcinomas, managed though conservative breast surgery and later analysed with the help of a classical histopathological technique, paraffin embedding. The carcinomas were assessed in terms of tumor size, lymph node status, histological type, correlation between invasive tumors and an situ carcinoma component, resection margins, grading and patients age. Following assessment, we looked at associations between above morphological and clinical parameters and ipsilateral local recurrences. We concluded that more than half of our cases were carcinomas, measuring between 2 cm and 5 cm, with no associated lymph node involvement, in keeping with pTNM criteria for stage II. By far, in our study, the most frequent histopathological type was type NOS (63.37%) followed by invasive lobular carcinoma (10.56%) and mixed ducto-lobular invasive carcinoma (6.27%). Other types of invasive carcinoma were rarer, each representing less than 4% of cases. In regards to in situ carcinomas we noted the most common histological types to be both cribriform intraductal carcinoma and comedocarcinoma, each identified in 1.65% of cases. Amongst invasive breast carcinomas, infiltrating ductal carcinoma not otherwise specified (NOS) was found to be most commonly associated with in situ ductal carcinoma lesions. This was seen in 34.9% of cases, and was the only type associated with an extensive in situ component. Analysing the grading of mammary carcinomas in our study showed that the vast majority of cases (63.04%) were grade 3 tumors. In regards to surgical resection margins, ¾ of cases were noted to have negative margins. Tumor recurrences were noted in 12 cases. These cases were most commonly noted to reoccur following initial poorly differentiated, infiltrating ductal carcinomas, not otherwise specified (NOS), with positive resection margins, measuring less than 2 cm. Patiens tended to be under the age of 40 and had positive lymph nodes. The emergence of local recurrences after conservative surgery for early breast cancer is singnificantly linked to poorly differentiated primary tumors (p <0.05) but not correlated with histological type, presence of extensive intraductal carcinoma component, size of primary breast tumor or lymph node status ( p> 0.05). In terms of increasing the risk of ipsilateral recurrence the most important aspect highlighted in our sudy was the status of the resection margins. Patients with positive resection margins had a significantly high risk to develop recurrences after the conservative surgery, compared to those with negative margins (p <0.001).

Keywords: breast cancer, breast conserving surgery, recurrence, histopathological

Corresponding: Tenea-Cojan T.S., Ph.D., Surgery Clinic of Hospital C.F. Craiova, Bld.Stirbei Voda 6; e-mail:doctortts@yahoo.com

DOI 10.12865/CHSJ.42.03.07 - Download PDF Histopathological Study on Conservatively Operated Breast Carcinomas PDF